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22. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin e. V.

Deutsches Netzwerk Evidenzbasierte Medizin e. V.

24. - 26.02.2021, digital

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Physicians’ adherence to the multidisciplinarity and recommendations of tumor boards is not only an attribute of certification

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  • Philip Fritz Sorge - Universitätsklinikum Halle (Saale), Krukenberg-Krebszentrum Halle (Saale), Halle (Saale), Deutschland
  • Susann Schulze - Universitätsklinikum Halle (Saale), Krukenberg-Krebszentrum Halle (Saale), Halle (Saale), Deutschland
  • Susanna Jaspers - Universitätsklinikum Halle (Saale), Krukenberg-Krebszentrum Halle (Saale), Halle (Saale), Deutschland
  • Christoph Thomssen - Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Gynäkologie, Halle (Saale), Deutschland
  • Regina Große - Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Gynäkologie, Halle (Saale), Deutschland
  • Mascha Binder - Universitätsklinikum Halle (Saale), Klinik für Innere Medizin IV, Hämatologie und Onkologie, Halle (Saale), Deutschland
  • Jan-Henning Klusmann - Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Pädiatrie I, Halle (Saale), Deutschland
  • Jessica Hoell - Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Pädiatrie I, Halle (Saale), Deutschland
  • Dirk Vordermark - Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Strahlentherapie, Halle (Saale), Deutschland
  • Claudia Wickenhauser - Universitätsklinikum Halle (Saale), Institut für Pathologie, Halle (Saale), Deutschland
  • Walter Wohlgemuth - Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Radiologie, Halle (Saale), Deutschland
  • Haifa Kathrin Al-Ali - Universitätsklinikum Halle (Saale), Krukenberg-Krebszentrum Halle (Saale), Halle (Saale), Deutschland

Who cares? – EbM und Transformation im Gesundheitswesen. 22. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin. sine loco [digital], 24.-26.02.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. Doc21ebmPS-4-07

doi: 10.3205/21ebm079, urn:nbn:de:0183-21ebm0792

Published: February 23, 2021

© 2021 Sorge et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background/research question: An interdisciplinary Tumorboard (TB) is a major medical requirement of the certification program of the German Cancer Society (DKG) to improve cancer care in Germany. In a cross sectional analysis, we evaluated the multidisciplinarity of TBs and adherence to the recommendations made between a certified and in 2018 not hitherto certified tumor centers.

Methods: In 2018, 4,100 cases were discussed in the 12 weekly TBs of the certified Krukenberg Cancer Center (KKH) of the University Medical Center in Halle (Saale). In the current evaluation, 714 TBs of 284 newly-diagnosed patients were included. The Breast Cancer Center (n=175) was chosen as the first regional (certified in 2004) organ-specific tumor center (center A). The Center of Hematology (n=83; center B) and the Center of Pediatric Oncology (n=26; center C) were selected as non-certified centers in 2018. Recommendations were classified into four groups according to the degree of implementation (100%, >50 – < 100%, 50%, < 50%). Nonconformity was considered to be present if ≤50% of recommendations were followed.

Results: Overall, 98.9%, 89%, and 100% of patients were discussed in TBs in A, B, and C respectively. All TBs were interdisciplinary. In addition to oncologists, representatives from pathology (93%), radiology (96%), and radiotherapy (93%) participated in the TBs of A. Corresponding figures for B and C were 89%, 95%, and 83% and 83%, 54%, and 70% respectively. The median number of recommendations per TB in A, B, and C was 3, 3, and 1 respectively. Overall, 72% of recommendations were fully implemented. Adherence was comparable in the three centers (A: 73%, B: 70, C: 77%). In addition to the 15.5% partially implemented recommendations, 11.8 % of recommendations showed nonconformity. Most important causes were patient wish, patient´s comorbidities, side effects of treatment, patient death, physicians' decisions, and missing follow-up. Centers B and C were successfully DKGcertified in 2019.

Conclusion: Irrespective of a DKG-certification, the evaluation shows no entity specific differences with most patients being discussed in multidisciplinary TBs. A certified Oncological Center such as the KKH fulfills all technical and medical requirements to provide the highest quality of cancer care. Yet, efficiency of TBs and adherence to recommendations might be further optimized by increased respect of patients` preferences and improved presentation of patient-related data.

Competing interests: Keine